Chapter 6 – Bone disease

Contributor: Evangelos Terpos

1 – Introduction

Multiple myeloma (MM) is a relatively common hematological malignancy characterized by the accumulation of abnormal plasma cells in the bone marrow. The hallmark of MM is bone disease characterized by the presence of lytic lesions and/or osteoporosis due to increased osteoclast activity, accompanied by suppressed osteoblast function. The clinical and economic impact of the associated bone pain and skeletal-related events (SREs; pathologic fractures, spinal cord compression [SCC], requirement for surgery or palliative radiotherapy to bone and hypercalcemia) can be devastating, with major effect on quality of life, survival, and treatment costs [1].